go back

California rates for HCPCS 28103

Excision or curettage of bone cyst or benign tumor, talus or calcaneus; with allograft

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,820.00 / $6,640.00 / $17,701.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$356.14 / $388.31 / $1,273.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,456.00 / $7,362.00 / $16,106.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$430.44 / $582.12 / $1,158.35
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.00 / $100.00 / $8,655.16
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$315.58 / $455.02 / $1,009.07
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,277.00 / $10,309.93 / $18,465.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$411.30 / $541.53 / $1,112.67
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$351.45 / $452.90 / $664.82
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$372.32 / $514.87 / $910.12
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,439.16 / $26,542.00 / $29,777.20
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,959.35 / $3,959.35 / $3,959.35
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $32.34
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$421.95 / $543.98 / $817.32
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$413.69 / $559.22 / $1,057.11
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,289.42 / $1,289.42 / $1,289.42
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$365.96 / $503.20 / $664.81
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,696.00 / $13,722.00 / $29,312.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$304.29 / $428.04 / $875.38